Citation Nr: 21032600 Decision Date: 05/27/21 Archive Date: 05/27/21 DOCKET NO. 17-46 595 DATE: May 27, 2021 ISSUES 1. Entitlement to a rating in excess of 30 percent for migraine headaches. 2. Entitlement to a compensable rating for allergic rhinitis and sinusitis. 3. Entitlement to special monthly compensation based on housebound. REMANDED Entitlement to a rating in excess of 30 percent for migraine headaches is remanded. Entitlement to a compensable rating for allergic rhinitis and sinusitis is remanded. Entitlement to special monthly compensation based on housebound is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1966 to June 1968. He received the National Defense Service Medal, Vietnam Service Medal, and Vietnam Campaign Medal with device. When this case was before the Board in February 2020, entitlement to a rating in excess of 30 percent for migraine headaches was denied and entitlement to a compensable rating for allergic rhinitis and sinusitis was remanded. The Veteran appealed the denial to the U.S. Court of Appeals for Veterans Claims (Court). In December 2020 the Court granted the parties' Joint Motion for Partial Remand (JMPR), returning the issue to the Board for action consistent with the terms of the joint motion. Therein, the parties agreed that the appellant had abandoned the issue of entitlement to an effective date earlier than September 23, 2016, for the award of an increased rating for migraine headaches; therefore, this issue is not in appellate status and will not be addressed by the Board. The Board finds that additional evidentiary development is required before adjudication of this case. In regard to the migraine headaches claim, the Veteran was last afforded a VA examination for his headaches in February 2017. Pursuant to the JMPR, the Board finds that remand is required to afford the Veteran a VA examination to address his migraine headache symptoms without regard to the ameliorative effects of pain medication. In regards to the allergic rhinitis and sinusitis claim, in response to the remand, the Veteran was afforded a VA examination in November 2020 and an addendum opinion was received in the same month in which the examiner stated that in review of the last examination of November 2020 he did not have a diagnosis of chronic sinusitis as his CT scan was normal. The examiner stated that given that the Veteran did not have chronic changes on CT, he did not carry a current diagnosis of chronic sinusitis; therefore, the Veteran only had a diagnosis of allergic rhinitis. However, the Board notes that in the November 2020 examination report, a diagnosis of "chronic sinusitis 2000s" was noted. Moreover, the Board previously noted that treatment records indicated that the Veteran frequently experienced sinusitis as showed in a June 2017 VA treatment record. Accordingly, on remand an addendum opinion should be obtained on remand that addresses the Veteran's documented medical history of sinusitis. Finally, the outcome of these claims may potentially impact the Veteran's eligibility for statutory housebound. As such, the special monthly compensation based on housebound claim is currently inextricably intertwined with other claims and therefore must also be remanded. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA neurological examination by a clinician with appropriate expertise to determine the severity of his service-connected migraine headaches. The electronic record, including a copy of this remand, must be made available to the examiner. All appropriate tests and studies should be conducted and clinical findings should be reported in detail. The examiner should describe the nature and severity of all manifestations of the Veteran's service-connected migraine headaches. In particular, the examiner must state whether there is any evidence of characteristic prostrating attacks, and the frequency thereof; and whether there are very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. The examiner should describe the severity of the Veteran's headache symptoms without the use of medications, and during flare-ups. If the examiner finds that the Veteran's reported symptoms do not result in prostrating attacks of headache pain, an explanation should be provided. All opinions provided must be thoroughly explained, and an adequate rationale for any conclusions reached should be provided. 2. Provide access to the electronic claims file to the November 2020 examiner, or appropriate substitute if required, to provide an addendum opinion. An examination should be performed if deemed necessary by the examiner providing the requested opinions. Following review of the electronic claims file, the examiner should provide an opinion regarding whether the Veteran has had a diagnosis of sinusitis at any point during the pendency of this claim. The opinion must include a discussion of the Veteran's documented medical history and assertions of frequent sinusitis, the November 2020 examination report that showed a diagnosis of "chronic sinusitis 2000s", and the aforenoted June 2017 VA treatment record. If sinusitis is diagnosed, the examiner must report all symptoms and functional impairments that result from the sinusitis, including the frequency with which the Veteran experiences incapacitating episodes of sinusitis. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be considered. If the examiner rejects the Veteran's reports, the examiner must provide a reason for doing so. All opinions provided must be thoroughly explained, and an adequate rationale for any conclusions reached should be provided. (Continued on the next page) 3. Then, after undertaking any additional development that is deemed warranted, readjudicate the claims on appeal with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, he and his representative should be furnished a supplemental statement of the case and afforded an appropriate period of time within which to respond thereto. MICHAEL A. PAPPAS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.M.K., Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.